EPS Nomination

Please complete this form to sign up to our prescription delivery service, ensuring that all the information is entered accurately. By filling in this form you are asking your doctor to send all your electronic prescriptions to our pharmacy. You can change this nomination at any time.

    Please select an option for where we can deliver your medication:
    Please enter any delivery notes (such as the house number of your neighbour, or your safe place):
    If you have an exemption, please enter the details here:
    By ticking this box you are consenting to your future prescriptions being sent electronically to The Care Pharmacy. We will then dispense your prescriptions and deliver them to you. You can change this nomination at any time.